Defining and measuring dysphagia following stroke.
OBJECTIVE
To continue the development of a quantified, standard method to differentiate individuals with stroke and dysphagia from individuals without dysphagia.


METHODS
Videofluoroscopic swallowing studies (VFSS) were completed on a group of participants with acute stroke (n = 42) and healthy age-matched individuals (n = 25). Calibrated liquid volumes of 3, 5, 10, and 20 ml were administered during the VFSS. Six measures in 3 domains of bolus flow (timing, direction, and clearance) were measured. Values of these measures obtained from the control group were used to classify dysphagia within the participants.


RESULTS
The use of a single measure or single liquid volumes to classify dysphagia did not distinguish between healthy adults and individuals following stroke with and without dysphagia. Abnormality on more than 1 measure across multiple volumes appears to be a more robust method in defining dysphagia for liquids.


CONCLUSIONS
Our findings indicate that the definition of dysphagia is critical in determining whether persons are classified with disordered swallowing. The definition is dependent on materials and measures evaluated. Each measure provides independent aspects to the evaluation. Determining the level of importance of each depends on the purpose of the evaluation.
Daniels
Stephanie K
SK
Michael E. DeBakey VA Medical Center, Houston, TX, USA. stephanie.daniels@va.gov
Schroeder
Mae Fern
MF
DeGeorge
Pamela C
PC
Corey
David M
DM
Foundas
Anne L
AL
Rosenbek
John C
JC
D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D014741:Video Recording